"That is happiness; to be disolved into something complete and great. When it comes to one, it comes as naturally as sleep." - Willa Cather

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Wednesday, 18 May 2011

The pregnancy competition

The title is misleading. I don't look at my pregnancy as a sort of competition with other women. But the idea of doing everything right is so attractive. Just as it is in any sort of race, of course. But if my last pregnancy was like a marathon, I basically had to drop out at mile 18 due to pelvic injury. But the analogy of course doesn't quite work because, despite that, I certainly didn't end up a loser and, instead, gave birth to the wonderful Lorax.

Today, I had my 30 week appointment with my midwife and I couldn't help feeling - "I am not only still running this marathon, but I am in the lead." (personality disorder? perhaps) I am, of course aware, it is uncharming to compare oneself to other pregnant women. And, truth be told, I wish everyone felt as good as I do. But I can't pretend for a second I believe that the fact that I feel a lot better than most women at 30 weeks is due to luck. But is the fact that nearly all of my measurements and vitals are on the verge of normal or abnormal possibly dangerous for the baby?

First in the exercise dept:

- in no part of my body do I feel injured or have pain- still able to do a back bend, can hold myself in a plank for about 2 minutes- have recently gotten close to cycling times comparable to prepregnancy times on the same routes- feeling ready for the marathon on Sunday

Vitals:- blood pressure was 99/48? (I always forget the diastolic), but the systolic has continuously dropped throughout pregnancy- Pulse 68- Baby's pulse around 110. (This had me worried for a second when we listened to the doppler and I thought the baby was me) But this is just barely within "normal" (nl. 110-160 bpm) and actually makes me think the baby has a very strong and healthy heart that it's pulse can dip so slow when he's sleeping. A very reliable sign of a healthy heart at any age is pulse variability. Plus the baby's heart rate should be just a little under double the mother's.-Weight gain 13 lbs (just below current recommendations for normal weight women)- Fundus measurement 24 cm (just below normal, but my midwife fudged on the sheet and called me 25 cm at 29 weeks to make it fit into the pretty "normal" gray bow)

So my weight gain, fundus measurement and baby's pulse are outside of the range of 95% of pregnant women. But despite this, neither I nor the midwife in any way got the impression that anything was wrong. But should we be worried? There is a lot that is unknown. But, then again... does it need to be known? Can the fact that I am otherwise healthy be the only reassuring factor needed? Well, threre is almost always a point at which things become dangerous. For example, one recent study from 2011 (a small study of 95 patients by William To in the Australian and New Zealand Journal of Obstetrics and Gynecology) showed low weight gain in pregnancy to be associated with not returning to prepregnancy bone mass two years later (regardless of whether or not one breastfeeds). That can definitely be a concern, for athletes in particular, and is one reason I am NOT complaining or worried about being a bit ahead of my weight gain this pregnancy compared to last.

At the end of my visit, my midwife, however, asked the very poignant question: "Will you be able to get yourself to calm down enough for the birth?" Ha. "Calming down" has never been my forté and it didn't take her long to figure that one out. I guess the plan is to try giving birth in water (I tried it last time, but it didn't work out) and she's trained in acupuncture for pain control, so that will probably also come in handy. But yeah, getting an epidural and falling asleep seemed to be what it took last time, but it sure would be nice to experience labor naturally.

In other news, I have mastered the art of peeing with shorts on and not getting wet. Now that I pee approximately every 9 minutes during my first hour of running, this will be extremely practical at the Copenhagen Marathon (where there is a sad paucity of bushes and trees!).

Running song of the day: Naked Kids by Group Love (a nice summer song)

But an even better sound is Natali reading to The Lorax right next to me. These are happy days...

25 comments:

I will tell you, I am very happy for you (and a little jealous) that you feel so amazing at 30 weeks. At 20 weeks, my running has slowed to barely a jog, and I have a lot of pain. What I wouldn't give to feel normal during a run. I think that means I'm losing in that department. ;)And I think it's so sweet that Natali is reading to the Lorax. What great kids you have!

I think you needn`t be worried. In Germany no one checks how you "measure" (probably we have more frequent ultrasounds) as it doesn`t tell much. "Measuring" depends so much on how the individual woman is build (tall, short, lean, big etc.). I would, however, have the bloodpressure checked again. In pregnancy an increase in blood pressure is desirable for it makes sure that the baby/placenta are nourished properly. Do you eat enough sodium? Against what some doctors still recommend you should never ever be on a low-sodium diet when pregnant as sodium helps fluid to remain in the bloodstream (protein does so as well) as opposed to leaking into the tissue (and possibly creating swelling). Your blood pressure might increase accordingly if you add some salt (in case you need to).

You sound so much like me with the calming down and relaxing, no wonder why my child is constantly on the move!Sounds like a great pregnancy so far, hope things continue to go so smoothly including the birth. I hear you on the epidural and sleep, that was my trick too as much as I fought an epidural it was the answer in the end.Good luck with the marathon and have fun :-)

Thanks for the comment. I totally agree about the measurement and I'm not worried, though my husband said "oh, God, so he's going to be a REALLY little squirt??".

Regarding blood pressure. First of all, I like your idea of eating salt and boy do I. Just because I crave it. I add salt to my sandwiches every day and douse my dinner in soy sauce. Mmmmm.

BUT, I very much disagree that having a low blood pressure while pregnant is unhealthy for the baby. ABSOLUTELY disagree. My systolic blood pressure has not been over 110 all pregnancy and that is because there is very little resistance in my blood vessles because I exercise so much and am not overweight (just had the elasticity of my blood vessels checked and have the blood vessels of a 19 year old woman). A woman's body is oh so finely tuned to deliver the right amount of blood to the baby. If a woman's blood pressure goes up later in pregnancy, it is a sign of increasing resistance in blood flow getting to the uterus and it is a BAD sign. And if the blood pressure is high enough, it is called preeclampsia, of course, and can get so high that the mother has seizures after giving birth (eclampsia). But just goes to show our bodies are MADE to get the right about of blood to that baby, regardless of the resistance.

Of course if I had heart failure or sepsis as the reason for my low blood pressure, we would be talking about a completely different (and almost opposite) scenario, in which the baby would be in danger.

There is absolutely no danger in a healthy pregnany woman having a systolic blood pressure of 99. And if you show me a study stating otherwise, it is a flawed study.

Hey there. My blood pressure is always really weirdly low during pregnancy, right up until like 35 weeks, when I get antsy, ha ha!I would wonder a bit about the fundal height -- like you, I always measured small, which didn't matter since I stayed on my own curve. But then I started measuring even smaller, falling off my curve, if that makes sense, and it was a low amniotic fluid issue (and got bad enough for inductions with both pregnancies -- it was below a 5). I'm not saying you have low fluid, but I would wonder about it.You are in the home stretch now, mama!

I'm very happy for you, your health, and the expected robust health of your baby.

I just think something about the beginning of that post struck me as a little smug. Maybe you did not mean it that way.

I get where you're coming from. I had 2 extremely easy pregnancies and couldn't help but feel almost giddy that my body was so "good at" the whole process. This third one has been smooth sailing for the most part, but I've developed skin issues requiring dermatological care, and I'm seeing a physical therapist for chronic tailbone pain. It has humbled me a bit and reminded me to thank my lucky stars for my general lack of pregnancy symptoms, and reminded me that for the most part, those who experience them are certainly not to blame. So, I applaud your continuing exercise, but I sense a tinge of looking down on others in there that's distasteful. If I'm imagining it, then nevermind, and I sincerely apologize for undue criticism.

Jacqueline, I had the same measurement at this time with the first pregnancy, so I'm not about to start worrying yet. But it is a good point!

Kate

I really love honest comments. Just as I love writing honest blog posts :). Things can go wrong in a pregnancy despite doing every possible thing "right". And it doesn't make me happy one bit to hear about your tailbone. I really do feel about it like I feel about a race, you can train and prepare and do everything and still have a relatively crappy race- BUT there are a bunch of things one can do to increase the chances of things going well. And that was my point. Had I not exercised and gained a ton of weight, I'd be feeling like crap now and would have had a much higher chance of developing problems and the same goes for every woman. I in no way think my body is better made for a good pregnancy than any other woman. No way! I'm just feeling right now like all of the careful training I have put in paid off and I feel great- just like one might feel when they run a big PR.

Would you believe me if I told you that one of the big reasons I love writing this blog is because maybe, just maybe I'll encourage/help other women to have a happy, healhty pregnancy?

But if I came off as smug, that wasn't my intention but simply must be the way I write. Plus I hate the idea of saying things in a delicate and pretty way so as not to offend - might as well just tell it like it is.

thanks for your reply. and I do think that you are succeeding in encouraging other women to have healthier pregnancies -- even me! Because while I'm no ultra runner (while pregnant or not), I can always think of you and remember geez, I've got no good excuse to not get out there and get off my duff (despite the bowling ball I'm carrying around in my stomach). : ) So kudos for that.

I will be honest, it did come across slightly smug. I feel lucky that I have had easy pregnancies too but I do think some of it is exactly luck. Yes, I take good care of myself and haven't gained a lot of weight either (exactly the ame as you, in fact) and have very low blood pressure but I think part of it is just what my body does in pregnancy. I don't take responsibility for the majority of it. I guess I have had plenty of friends who felt terrible during pregnancy and would have loved to be more active or gain less weight but that doesn't mean they "failed" at pregnancy. I think it is a weird way to look at it- who is "better" at being pregnant. Just do your thing because you love it, not because you want to show up the next pregnant woman.

Awesome post. You should be proud of your body. As someone who did well (until 37 weeks!)...I never felt better than any other woman...just proud of my body. I always had low blood pressure in pregnancy, too. Measured small and she was 7lbs 9oz.

I am SOOOO happy you aren't experiencing pain like I did. I hope you don't and hope you continue to run awesome and pain free!

Well, I don't believe in luck. But it's very, very complicated. If a woman wins a gold medal at the Olympics in Gymnastics, is it luck? Well, most people would say no. There are, however, a lot of factors that were out of that woman's control, as there are with everything in life. She just worked hard with what she had - and would anyone blame her for feeling happy upon winning? No! So why are people mad at me when I had one pregnancy where I was sidelined at 26 weeks with terrible pain and then one that ended in miscarriage, that I am happy now? Just as the last two pregnancies, there are a number of things that have been totally out of my control - but the fact that it worked out well this time is not a simple matter of luck. And it's not a matter of luck for you either, Allison. If you went around saying "well, I feel so good simply because I'm lucky", you're ignoring all of the things you have worked hard to do right. So way to go and I don't take YOUR comment as bragging or smug - of course you should be happy you are healthy and things are going well.

Let me add one thing. I would never look at a pregnant woman and think "she failed". Our lives are so amazingly different. We can never know the whole story - or what the woman wanted from the pregnancy (if she wanted it).

People who work in Ob-Gyn can at times be very good at thinking a woman has failed. I remember a 24 year old woman who was pregnant for the 9th time. She had AIDS and was addicted to heroine and cocaine. She did not use birth control. Out of the nine pregnancies, she had 4 kids that survived, all with health problems, all in foster care. Again, there is no unlucky or lucky here. But I wouldn't look at her and say she failed and judge her. It simply made me extremely sad to watch her give birth at 16 weeks and see that tiny baby take a few breaths and die. It made me extremely sad for her. The best way to look at it for everyone who has a bad outcome is - what can be done different, not "she failed". That's my extreme example.

So glad you are feeling happy and healthy! I am almost 20 weeks pregnant and starting to wonder, however, how much of our own pregnancy well-being is really in our control? Like you, I was super-fit at the beginning, low body fat, lots of running, and I kept it up until a week ago Wednesday, when I was suddenly slammed with some virus that has kept me in bed, feeling terrible, since (oh, and now I have a bacterial ear infection as well). I felt GREAT up until then and was a bit self-congratulatory as well, feeling that it must be some combination of luck and my own awesomeness in keeping up my running and workouts. I even ran a race (slowly). Now I am sitting here, having left the house exactly twice in the last week, deaf in one ear and wondering where the heck I went wrong :)Ok, I guess virus/infection is not quite the same as deciding to quit exercising, start eating, and gain 100 lbs and ending up with high blood pressure and lots of other problems. My point is just that luck seems to play a large role. You might feel just as good if you didn't run quite so much, you know?

I had also understood that lower blood pressure is more desirable during pregnancy. Mine was 95/55 at my last appointment and the doctor seemed happy!

Sorry about that virus! I have also had way more viruses while pregnant than I normally do - but nothing like you describe.

Your comment made me realize I should make something clear - just because I don't believe in "luck" doesn't mean I believe we can control everything. There are SO many factors that are out of our control in a pregnancy - and a lot of those things have just worked in my favor and are not related to my own actions. Some might call it luck, I'll just call it "external factors".

Truly I think it it's just the way it sounds when you write it, I highly doubt you are truly arrogant or smug in person. I thought about it last night and I suppose I should take some credit for having a healthy pregnancy but again, I almost feel guilty for that fact since many friends have had a rough time and just couldn't be that active for no fault of their own.

I should say that i do think it is great that you have felt so good. I can't believe that I am sitting here at 29+ weeks and feel so good. I definitely am not running like you are but doing some intervals still and hard group exercise classes without any pain. I was totally sidelined at this point last time with the pubic bone pain and am overjoyed that I missed that this time.

No doubt you inspire a lot of pregnant runners but I also worry that there are women who might read your blog and think badly about themselves because they cannot be active or have gained more weight than planned or have higher BP. There will always be someone at either end of the continuum and you are luckily (yep, still think some of it is luck along with your hard work) at the "good" end. I just think the humble approach comes across less abrasively. None of this was meant as attack, of course, just giving you some thoughts. :)

Allison - I think we agree. A lot of both of our good fortune is due to factors beyond our control - so in that way we are "lucky". I just don't call it luck because luck implies some large, unidentifiable force. But to a scientist, everything is potentially identifiable. Maybe we're 50% responsible for things going well? Maybe less, I'm not sure. But we both did a lot to make a happy, healthy pregnancy more likely!

I just want to clarify, (and I shouldn't speak for anyone else but will go out on a limb here and do so anyway) -- I don't think anyone's "mad" at you for being happy now. You should be, and we are happy for you!

I am pregnant too. I also run. Not as far as you, of course (because you are the "leader" in the pregnancy race), but I still run. I ran with my last pregnancy too. Pregnancy is horrible for me. I battle morning sickness and vomiting for months even well into the middle of my second trimesters. Despite all of this, I still manage to gain an upper level of normal amount of weight. And guess what? My blood pressure is healthy. It's lower than yours, even. Guess you aren't the leader in everything ;)

"The title is misleading. I don't look at my pregnancy as a sort of competition with other women."

Anon, I am so sorry you are still not feeling well. I really hope it gets better. How far along are you? I felt like absolute crap the entire first trimester and it gradually got better over the second and now I feel really good (finally!). I'm just guessing it has something to do with persisting in exercising and keeping the weight gain down. Good luck with the rest of your pregnancy :).

My point with brining up the blood pressure was more to pose a question - IS a very low blood pressure necessarily better? Well, probably, but we don't know (so many of these parameters simply lack research). So it's hard to point out a "leader" and, of course, it is absurd to do so.

Hello from Rude Skov

Photo by Stine Sophie Winckel

...

My name is Tracy. I am a physician scientist from the USA, living with my husband and two young boys in Denmark. I work as a post-doc fellow at Næstved Hospital. I have a scientific interest in vision loss, vision loss during exercise, exercise, running during pregnancy, MAF training as well as nutrition and health for athletes. I also have a love for music, physics, statistics, cycling, yoga, cross-country skiing, bla bla bal.

I was a member of Team USA at the IAU World Championships in Ultra Trail Running in 2013 in Wales. I am now training to run with Team Denmark at the IAU World Championships in Annency, France in May 2015.